Comparative analysis of clinical treatment outcomes: Breath-hold vs. free-breathing techniques in liver stereotactic body radiotherapy.

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Oncology Pub Date : 2024-10-20 DOI:10.1111/1754-9485.13793

Kosuke Morishima, Hideomi Yamashita, Tomoyuki Noyama, Atsuto Katano

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Abstract

Introduction: The aim of this study was to clarify the safety and efficacy of breath-hold irradiation in liver stereotactic body radiotherapy (SBRT).

Methods: A retrospective analysis was conducted on 57 consecutive patients who received SBRT for hepatocellular carcinoma or liver metastases between 2013 and 2021. Breath-hold irradiation was implemented for patients treated after April 2020.

Results: The median follow-up period for all patients was 16.4 months (IQR: 7.36-20.9). The 2-year overall survival rate was 64.4% (95% CI: 47.4-77.2), and the local control rate was 84.3% (95% CI: 69.7-92.3) for all patients. The 1-year overall survival was 80.0% (95% CI: 60.8-90.5) versus 82.0% (95% CI: 53.5-93.9) in the free-respiratory (FR) group versus the breath-hold (BH) group, respectively (P = 0.60). The 1-year local control rates were 78.1% (95% CI: 57.5-89.5) in the FR group and 95.7% (95% CI: 72.9-99.4) in the BH group, respectively (P = 0.16). Radiation-induced liver injury, defined by an escalation of ≥2 in Child-Pugh score, was observed in four patients within each group (FR 13% vs. BH 15%). There were no gastrointestinal adverse events of Grade 3 or higher.

Conclusion: Breath-hold irradiation can be safely administered and has demonstrated clinical potential in improving local control. Further research into dose escalation using breath-hold techniques is warranted.

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临床治疗效果对比分析：肝脏立体定向体放射治疗中的屏气与自由呼吸技术。

导言本研究旨在明确屏气照射在肝脏立体定向体放射治疗（SBRT）中的安全性和有效性：方法：对2013年至2021年间连续接受SBRT治疗肝细胞癌或肝转移的57例患者进行了回顾性分析。结果：所有患者的中位随访期均为2年：所有患者的中位随访时间为16.4个月（IQR：7.36-20.9）。所有患者的2年总生存率为64.4%（95% CI：47.4-77.2），局部控制率为84.3%（95% CI：69.7-92.3）。自由呼吸（FR）组与屏气（BH）组的1年总生存率分别为80.0%（95% CI：60.8-90.5）和82.0%（95% CI：53.5-93.9）（P = 0.60）。自由呼吸组和屏气组的 1 年局部控制率分别为 78.1%（95% CI：57.5-89.5）和 95.7%（95% CI：72.9-99.4）（P = 0.16）。各组中均有四名患者观察到辐射诱导的肝损伤，定义为 Child-Pugh 评分≥2 分（FR 组 13% 对 BH 组 15%）。没有出现3级或以上的胃肠道不良反应：结论：屏气照射可以安全实施，在改善局部控制方面具有临床潜力。使用屏气技术进行剂量升级的进一步研究是有必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Medical Imaging and Radiation Oncology 医学-核医学

CiteScore

3.30

自引率

6.20%

发文量

133

审稿时长

6-12 weeks

期刊介绍： Journal of Medical Imaging and Radiation Oncology (formerly Australasian Radiology) is the official journal of The Royal Australian and New Zealand College of Radiologists, publishing articles of scientific excellence in radiology and radiation oncology. Manuscripts are judged on the basis of their contribution of original data and ideas or interpretation. All articles are peer reviewed.